Field Trip Reservation Field Trip Date*This information is required1st Choice* MM slash DD slash YYYY 2nd Choice* MM slash DD slash YYYY 3rd Choice* MM slash DD slash YYYY Contact Details*This information is requiredName of School or Organization* Name of Teacher or Group Leader* First Last Job Title / Position* Email* School Phone Number*Day of Field Trip Phone Number*School or Organization Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are there any other contacts who you’d like us to list? If so, list their names and email address(es).School or Organization Affiliation* Elementary Middle High School Private Homeschool K-8 Daycare College/University Other Other Affilliation* Have you previously planned a field trip to Farm Wisconsin?* Yes No I'm not sure How did you hear about Farm Wisconsin?* Previous field trip to Farm Wisconsin General visit to Farm Wisconsin Social Media Farm Wisconsin website Wisconsin State Fair Referred by another teacher Drove by facility Other Other* Number of Attendees (Enter The Number of Students in Each Grade Level)*This information is requiredK3 K4 K5 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Number of Teachers Attending* Note: Our minimum chaperone requirement is one adult for every 15 students/youth attending. All teachers receive complimentary admission.Number of Additional Adults Attending* Note: For every 15 students/youth in attendance, you will receive one complimentary adult admission.Arrival & Departure Times / Additional Details*This information is requiredPreferred Arrival Time* 9:00am 9:30am 10:00am 10:30am 11:00am 11:30am 12:00pm 12:30pm 1:00pm Preferred Departure Time* 11:00am 11:30am 12:00pm 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm How Will Your Group Be Arriving At Farm Wisconsin?* Standard School Bus Coach Bus Small Group Bus Individual Vehicles Other Other - Please Explain* Number of Buses Arriving*Please Choose One1 Bus2 Buses3 Buses4 Buses5 BusesAre You Comfortable With Your Students Potentially Seeing a Live Calf Birth?* Yes No Would You Like To Include Barnyard Adventure Time?**Note this is an outdoor playground. Barnyard playground free time No Would You Like To Schedule a Beginner STEM Lab For Your Visit?*Note: Beginner STEM labs have an add-on fee of $2/student. Read about each STEM lab here: https://farmwisconsin.org/visit/fieldtrip/beginner-stem-labs/ Egg-ceptional Poultry Craving Cranberries (*Only available Sept - Dec) Strawberry DNA Extraction Color Taste Test No Would You Like To Schedule an Advanced STEM Lab For Your Visit?*Note: Advanced STEM labs have an add-on fee of $5/student. Read about each STEM lab here: https://farmwisconsin.org/visit/fieldtrip/advanced-stem/ Feeding the Modern Dairy Cow Caring for Calves Dos & Don'ts of Labor and Delivery I want to customize a lab based on my curriculum goals No Would You Like to Eat Lunch at Farm Wisconsin Discovery Center?* Yes ($10 lunch clean-up fee) No Cold, bag lunches may be brought to Farm Wisconsin and eaten on site. A $10 fee will be charged to all groups who bring in their own lunches to cover costs associated with clean-up.Is Your Group Planning To Order Boxed Lunches From Farm Wisconsin?* Yes No Special Needs or AccommodationsOptionalIf you have any attendees that need special accommodations, and/or who have any special needs we should know about, please describe below.Additional NotesOptionalPlease list any additional notes, requests, program preferences, and/or any other special information we should be aware of.Billing Details*This information is requiredReservation Deposit* Price: Deposit $50 to make your reservation. Once we receive your reservation we will confirm date and time via email. Full payment is required at least (1) week prior to your visit date. No refunds will be issued for cancellations with less than two (2) weeks notice or for "no shows." All payments are non-refundable and there are no refunds for persons missing on the day of trip. School Group admission rates only apply during the academic school year.Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secure Credit Card Card Holder* Card Number* Card Expiration* Card CVV* Total $0.00 CAPTCHA
